Department of Chemotherapy and Radiotherapy, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, 109 Xueyuan West Road, Lucheng District, Wenzhou City 325027, China.
Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Tianjin's Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin Medical University, Tianjin 300060, China.
Dis Markers. 2019 Jan 2;2019:7606128. doi: 10.1155/2019/7606128. eCollection 2019.
The prognostic value of preoperative anemia in gastric cancer remains unclear. Therefore, the purpose of the present study is to evaluate the prognostic value of preoperative anemia in gastric cancer.
We searched Embase and PubMed databases for relevant studies from inception to March 2018. The prognostic value of preoperative anemia in gastric cancer was determined by calculating the hazard ratio (HR) and the corresponding 95% confidence interval (CI) as effect measures. A random effect model was used in cases in which there was significant heterogeneity; otherwise, a fixed effect model was used. Statistical analyses were performed using Stata software.
Seventeen studies involving 13,154 gastric cancer patients were included. The estimated rate of preoperative anemia was 36% (95%CI = 27-44%). The overall survival of preoperative anemia was poor (HR = 1.33, 95%CI = 1.21-1.45). Moreover, disease-free survival was significantly lower in patients with preoperative anemia compared with those without this condition (HR = 1.62, 95%CI = 1.13-2.32). These findings were corroborated by the results of subgroup analyses.
The results indicate that preoperative anemia predicts poor prognosis in gastric cancer, including overall survival and disease-free survival. Therefore, preoperative anemia may be a convenient and cost-effective blood-derived prognostic marker for gastric cancer.
术前贫血对胃癌的预后价值仍不清楚。因此，本研究旨在评估术前贫血对胃癌的预后价值。
我们检索了 Embase 和 PubMed 数据库，从建库到 2018 年 3 月，收集术前贫血与胃癌预后关系的相关研究。采用风险比（HR）及其 95%置信区间（CI）作为效应量来评估术前贫血对胃癌的预后价值。如果存在异质性，则采用随机效应模型；否则，采用固定效应模型。使用 Stata 软件进行统计学分析。
共纳入 17 项研究，包含 13154 例胃癌患者。术前贫血的估计发生率为 36%（95%CI=27%-44%）。术前贫血患者的总体生存率较差（HR=1.33，95%CI=1.21-1.45）。此外，与无术前贫血的患者相比，术前贫血患者的无病生存率明显降低（HR=1.62，95%CI=1.13-2.32）。亚组分析的结果也证实了这一点。
这些结果表明，术前贫血预示着胃癌患者预后不良，包括总体生存率和无病生存率。因此，术前贫血可能是一种简便、经济有效的胃癌预后血液标志物。
